Abstract
Purpose: :
To report rates of intraocular pressure spikes in open angle glaucoma patients undergoing uncomplicated phacoemulsification surgery using difluprednate ophthalmic emulsion 0.05% qd postoperatively.
Methods: :
Retrospective chart review using electronic health records was used for 24 patients who had a diagnosis of open angle glaucoma but were not known steroid responders and who were currently using pressure lowering medications, had undergone slt or both.
Results: :
Avg preop IOP was 19.3 mm Hg. 17/24 patients were currently on prostaglandin, 5 on combination drop, 9 had undergone slt. 2 patients were on 2 IOP lowering meds, another 2 were on 3 medications. Avg IOP on POD1 was 22.5. 16.5% of patients had an iop spike of >10mm Hg (avg 17 mm Hg) and 37.5% had a spike of >5 mm Hg. 7 patients were treated with drops, 5 only discontinued durezol, 4 had no change to regimen. All IOPs were normal at week 6 with average IOP 13 mm Hg.
Conclusions: :
Glaucoma patients even without a history of steroid response are more likely to develop IOP spikes after surgery and with any steroid use. Difluprednate is a strong steroid and may cause early and significant elevations of IOP after uneventful cataract surgery. Caution should be used with postoperative difluprednate in patients with a known history of glaucoma.
Keywords: intraocular pressure • drug toxicity/drug effects • cataract